Those who firmly believe in the harmlessness of hormonal contraceptives are not recommended to read this article - you will find too much negativity in it. At the same time, knowing the consequences of taking hormonal medications to prevent unwanted pregnancy is necessary and very important for every woman. Own information, even if it concerns such an unpleasant aspect as , vital. Only in this case can you protect yourself from serious illnesses and disruptions in the normal functioning of all body systems, which can result from the use of artificial hormones.
First, some general information. When a person is healthy, when all organs and systems are working normally, all processes in his body are regulated. Consequently, the hormonal background is also in order, since hormones are produced in the required quantities.
Harm of hormonal contraceptives lies in the fact that they rudely interfere with this mechanism, fine-tuned by nature itself. And as we know, any violent intervention from the outside cannot but cause negative reactions, consequences, and changes.
The use of hormonal contraceptives for several years leads to rapid aging of the entire body, which in the future becomes impossible to prevent and stop. But the most severe consequences of taking birth control pills are suffered after the end of the course. The body “gets used” to artificial hormones, and when their quantity decreases sharply, the entire hormonal system as a whole experiences severe stress. All the forces of a woman’s body are now aimed at restoring the ideal balance, but, unfortunately, it is no longer possible to return to the original state. Therefore, after such shocks, the functions of the body completely deteriorate.
Hormones suppress the maturation and release of the egg, damage the functions of the ovaries (sex glands), and inhibit the regulatory functions of the hypothalamus. That is, natural connections are grossly violated and in their place there appear connections of artificial interaction between all parts of the genitourinary (primarily) system. As a result, the ovaries become smaller, the blood vessels in them narrow, and the supply of nutrients decreases. It becomes impossible for the ovaries to function normally. Exactly the same changes take place in all other parts of the female reproductive system.
Under the influence of contraceptive drugs, changes occur in the uterine mucosa that can lead to precancerous diseases. The tissue structure of the cervix can become so damaged that it causes the formation of cancerous tumors. Any deviation in the functioning of the genital organs is certainly reflected in the structure of the tissues of the mammary glands, as a result of which the risk of adenomas, nodular and diffuse mastopathy, and breast cancer increases.
Harm of hormonal contraceptives oral administration is also observed when they enter the gastrointestinal tract. The tablets become an irritant for the mucous membranes of the stomach and intestines, resulting in the development of gastritis, ulcers, and duodenitis. The natural flora of the gastrointestinal tract is noticeably disrupted, which leads to diseases such as dysbiosis and colitis.
The liver, pancreas, kidneys - all these important organs also fall under the negative influence of artificial hormones. Under the influence of toxic substances, which, in fact, are hormonal contraceptives, these organs are destroyed, which causes the occurrence of cirrhosis, hepatitis, liver adenoma, pancreatitis and cholecystitis, and diabetes.
Next, the composition of the blood changes, its coagulability increases, and thromboembolism begins. As a result, the risk of myocardial infarction and stroke increases even at a young age. As a result of long-term use of hormonal drugs, the condition of the blood vessels worsens, which automatically leads to hypertension, increased blood pressure, etc. The functioning of the urinary and endocrine systems is disrupted. The functions of the thyroid gland become completely imbalanced, and noticeable changes occur in the functioning of the immunological system.
Under the influence of hormonal contraceptives, metabolism is disrupted, which means rapid weight gain occurs. The nervous system is also affected, which affects the woman’s normal sleep and behavior. This manifests itself in insomnia, irritability, unreasonable aggression, frequent depression, and headaches.
Everything we have talked about is far from a complete picture of all possible negative changes occurring in a woman’s body under the influence of hormonal drugs. Of course, in some cases, when hormones are prescribed as a treatment for serious illnesses or as a means to treat infertility, their use is justified. As for hormonal contraceptive drugs, you need to think seven times before choosing this particular method of birth control for yourself.
Contraception is not only protection against unwanted pregnancy, but also a way to maintain health and the opportunity to give birth to the desired healthy child.
Family planning is a contraceptive priority. Currently, the choice of modern contraceptive methods is very large. It is best to seek advice from a specialist on choosing a contraceptive method, rather than trying to choose them yourself, since each method has its own contraindications and side effects, which depend on the woman’s age.
Incorrectly selected methods of contraception can not only be useless, but also cause complications in the hormonal, genitourinary, cardiovascular systems, as well as the gastrointestinal tract and other systems and organs of a woman. The essence of hormonal contraception is the use of synthetic estrogen and progestogen or only progestogen components, which are analogues of a woman’s natural sex hormones. Hormonal contraception is an effective and most common method of birth control.
There is the following classification of hormonal contraceptives:
- combined estrogen-progestogen oral contraceptives;
- progestin contraceptives:
- oral contraceptives containing microdoses of gestagens (mini-pills);
- injection;
- implants;
- vaginal rings with estrogens and gestagens.
As a result of the action of these contraceptives, growth, development of follicles and ovulation are simply not possible. Progestogens increase the viscosity of cervical mucus, making it impassable for sperm, and gestagens slow down the peristalsis of the fallopian tubes and the movement of the egg through them, as a result of which implantation of the fertilized egg, if fertilization does occur, becomes impossible.
Combined contraceptives, depending on the level of ethinyl estradiol, are divided into high-dose (they are not used now), low-dose, micro-dose.
Side effects and complications.
A small percentage are women who, when taking these contraceptives in the first months of use, experience nausea, vomiting, swelling, dizziness, heavy bleeding during menstruation, irritability, depression, increased fatigue, and decreased libido. Now such symptoms are considered in the form of the body’s adaptation to the drugs; they usually disappear by the end of the third month of constant use.
A more serious side effect of taking combined oral contraceptives is the effect on the hemostatic system. The estrogen component included in COCs increases the risk of coronary and cerebral thrombosis. However, this applies only to women at risk, namely women over 35 years of age, smokers, obesity, arterial hypertension, etc. It has been proven that the use of these contraceptives does not affect the hemostatic system of healthy women.
Under the influence of estrogen, blood sugar levels increase, resulting in latent forms of diabetes. Gestagens have a negative effect on fat metabolism, as a result, with an increase in cholesterol levels, the risk of developing atherosclerosis and vascular diseases increases. The effect of modern third-generation COCs, which contain gestagens, is exactly the opposite, that is, it does not disrupt lipid metabolism, but protects the vascular walls. An increase in body weight under the influence of gestagens is not observed when taking modern COCs. Acne and various rashes are possible when taking gestagens with a pronounced androgenic effect. The modern highly selective gestagens used, on the contrary, have not only a contraceptive, but also a therapeutic effect. Remember that combined oral contraceptives cause swelling of the cornea of the eye, which causes some discomfort for those who use contact lenses.
With long-term use of combined oral contraceptives, the vaginal microflora changes, which contributes to the development of bacterial vaginosis and vaginal candidiasis. The use of these contraceptives is a risk factor for the transition of cervical dysplasia (if any) to carcinoma. Women taking COCs must undergo cervical smears for medical examination. Any component included in the COC may cause an allergic reaction. The most common and frequent side effect of COC use is uterine bleeding.
The causes of bleeding may be a lack of hormones for a particular patient (estrogens - when bleeding appears in the first half of the cycle, gestagens - in the second half). In most cases, such bleeding disappears on its own within the first 3 months of taking COCs and does not require their discontinuation. COCs do not have any adverse effect on a woman's fertility. It recovers within the first three months, from the day you stop taking contraceptives. With the occasional use of COCs in the early stages of pregnancy, no side effects were identified, and no negative effects on the fetus were observed.
Modern contraceptives provide women with many options that were previously unthinkable. Contraception, planning, choosing a convenient time to start menstruation, reducing discomfort, including pain during “these days” - all this has become available now. The variety of options allows most women to easily choose a convenient method of taking birth control for themselves. However, many still do not have enough information about contraception, and in addition, there are a large number of myths that both women and men believe. Several such myths were debunked by gynecologists who commented to Business Insider.
You can't get pregnant while taking birth control pills
Of course, this is not true. None of the contraceptives provide an absolute guarantee that a woman will not become pregnant. Even sterilization is less than 100% effective, although more than 99%.
Postcoital contraceptives work 100% of the time
And that's not true. Emergency contraception in the form of a pill taken the day after intercourse delays ovulation, and if there is no egg that can be fertilized, pregnancy does not occur. However, ovulation could have already occurred, and then such pills are useless. There are other means of emergency contraception, for example, an intrauterine contraceptive made from copper, but its effectiveness is less than 100%.
Hormonal contraceptives are toxic and unnatural
Yes, hormonal birth control has its disadvantages, but in most cases the advantages outweigh them. It is necessary to consult a doctor and not prescribe the remedy yourself - then the likelihood that it will be suitable will be much higher. For example, the condition of patients in many cases improves if they take hormonal contraceptives.
You need to take the pills at the same time every day
Not always. It depends on the type of pills - if they contain only progesterone, then yes, indeed, they need to be taken on time. Otherwise, the effect of the pill wears off after 26 hours, and you need to use barrier contraception to avoid unwanted conception. If the pills contain both progesterone and estrogen, the “window” becomes larger, and a few hours of difference do not matter. However, doctors still recommend sticking to the same time for taking pills so that the appropriate habit is formed.
Missing periods caused by taking birth control pills is harmful
In some cases, women skip a week of placebo pills and immediately move on to the next pack of birth control, and sometimes they leave the hormonal ring for four weeks instead of three. Sometimes remedies imply complete absence. All this is safe. The women themselves may think that in such cases the blood stagnates inside, but this is not so - in fact, there is simply nothing to leave the body, the endometrial layer remains thin.
Intrauterine contraceptives are a mini-abortion
Wrong. Such drugs prevent the fertilization of the egg and prevent it from attaching to the uterus. It doesn't come to an abortion - the sperm simply don't have time to meet the egg. A thick layer of mucus forms, which is aggressive for sperm. Hormonal IUDs work slightly differently, but the general principle is the same.
Postcoital contraceptives lead to abortion
Also incorrect for the same reasons as described earlier. The principle of operation of a postcoital contraceptive is to delay ovulation, which means that fertilization also does not occur.
The pill may affect fertility
The pills themselves do not affect fertility, but sometimes women are prescribed them due to irregular menstruation or hormonal imbalance. When a woman stops taking hormonal contraceptives, the problems return and the same problems may arise as before the pills. In addition, fertility decreases with age. In any case, the pills have nothing to do with it.
Intrauterine contraceptives affect fertility
Previously, IUDs and other contraceptives were made from materials that could cause inflammation in the uterus. Now technology has stepped forward, and these contraceptives are completely safe. In some cases, they may even have an anti-inflammatory effect.
Women taking oral contraceptives gain weight
If the pills are chosen correctly, they will not cause weight gain. Perhaps they appear for completely different reasons - for example, young girls often begin to use contraception, and they begin to gain weight due to age factors or changes in lifestyle.
From previous publications we know about the abortifacient effect of hormonal contraceptives (GC, OK). Recently in the media you can find reviews of women who suffered from the side effects of OK, we will give a couple of them at the end of the article. To shed light on this issue, we turned to a doctor who prepared this information for the ABC of Health and also translated for us fragments of articles with foreign studies on the side effects of GCs.
Side effects of hormonal contraceptives.
The actions of hormonal contraceptives, like other medications, are determined by the properties of the substances they contain. Most birth control pills prescribed for routine contraception contain 2 types of hormones: one gestagen and one estrogen.
Gestagens
Progestogens = progestogens = progestins- hormones that are produced by the corpus luteum of the ovaries (a formation on the surface of the ovaries that appears after ovulation - the release of the egg), in small quantities - by the adrenal cortex, and during pregnancy - by the placenta. The main gestagen is progesterone.
The name of the hormones reflects their main function - “pro gestation” = “to [maintain] pregnancy” by restructuring the endothelium of the uterus into the state necessary for the development of a fertilized egg. The physiological effects of gestagens are combined into three main groups.
- Vegetative influence. It is expressed in the suppression of endometrial proliferation caused by the action of estrogens and its secretory transformation, which is very important for a normal menstrual cycle. When pregnancy occurs, gestagens suppress ovulation, lower the tone of the uterus, reducing its excitability and contractility (“protector” of pregnancy). Progestins are responsible for the “maturation” of the mammary glands.
- Generative action. In small doses, progestins increase the secretion of follicle-stimulating hormone (FSH), which is responsible for the maturation of follicles in the ovary and ovulation. In large doses, gestagens block both FSH and LH (luteinizing hormone, which is involved in the synthesis of androgens, and together with FSH ensures ovulation and progesterone synthesis). Gestagens affect the thermoregulation center, which is manifested by an increase in temperature.
- General action. Under the influence of gestagens, amine nitrogen in the blood plasma decreases, the excretion of amino acids increases, the secretion of gastric juice increases, and the secretion of bile slows down.
Oral contraceptives contain various gestagens. For some time it was believed that there was no difference between progestins, but it is now certain that the difference in molecular structure provides a variety of effects. In other words, progestogens differ in spectrum and in the severity of additional properties, but the 3 groups of physiological effects described above are inherent to all of them. The characteristics of modern progestins are reflected in the table.
Pronounced or very pronounced gestagenic effect common to all progestogens. The gestagenic effect refers to those main groups of properties that were mentioned earlier.
Androgenic activity characteristic of not many drugs, its result is a decrease in the amount of “good” cholesterol (HDL cholesterol) and an increase in the concentration of “bad” cholesterol (LDL cholesterol). As a result, the risk of developing atherosclerosis increases. In addition, symptoms of virilization (male secondary sexual characteristics) appear.
Explicit antiandrogenic effect only three drugs have it. This effect has a positive meaning - improvement in skin condition (cosmetic side of the issue).
Antimineralocorticoid activity associated with increased diuresis, sodium excretion, and decreased blood pressure.
Glucocorticoid effect affects metabolism: the body's sensitivity to insulin decreases (risk of diabetes), the synthesis of fatty acids and triglycerides increases (risk of obesity).
Estrogens
Another component of birth control pills is estrogens.
Estrogens- female sex hormones, which are produced by the ovarian follicles and the adrenal cortex (and in men also by the testicles). There are three main estrogens: estradiol, estriol, estrone.
Physiological effects of estrogens:
- proliferation (growth) of the endometrium and myometrium according to the type of their hyperplasia and hypertrophy;
— development of genital organs and secondary sexual characteristics (feminization);
- suppression of lactation;
- inhibition of resorption (destruction, resorption) of bone tissue;
- procoagulant effect (increased blood clotting);
- increasing the content of HDL (“good” cholesterol) and triglycerides, reducing the amount of LDL (“bad” cholesterol);
- retention of sodium and water in the body (and, as a result, increased blood pressure);
— ensuring an acidic vaginal environment (normal pH 3.8-4.5) and the growth of lactobacilli;
- increased antibody production and phagocyte activity, increasing the body's resistance to infections.
Estrogens in oral contraceptives are needed to control the menstrual cycle; they do not take part in protection against unwanted pregnancy. Most often, the tablets contain ethinyl estradiol (EE).
Mechanisms of action of oral contraceptives
So, taking into account the basic properties of gestagens and estrogens, the following mechanisms of action of oral contraceptives can be distinguished:
1) inhibition of the secretion of gonadotropic hormones (due to gestagens);
2) a change in vaginal pH to a more acidic side (the influence of estrogens);
3) increased viscosity of cervical mucus (gestagens);
4) the phrase “ovum implantation” used in instructions and manuals, which hides the abortive effect of GC from women.
Commentary by a gynecologist on the abortifacient mechanism of action of hormonal contraceptives
When implanted into the wall of the uterus, the embryo is a multicellular organism (blastocyst). An egg (even a fertilized one) is never implanted. Implantation occurs 5-7 days after fertilization. Therefore, what is called an egg in the instructions is in fact not an egg at all, but an embryo.
Unwanted estrogen...
In the course of a thorough study of hormonal contraceptives and their effects on the body, it was concluded that undesirable effects are associated to a greater extent with the influence of estrogens. Therefore, the lower the amount of estrogen in the tablet, the fewer side effects, but it is not possible to completely eliminate them. It was precisely these conclusions that prompted scientists to invent new, more advanced drugs, and oral contraceptives, in which the amount of the estrogen component was measured in milligrams, were replaced by tablets containing estrogen in micrograms ( 1 milligram [ mg] = 1000 micrograms [ mcg]). There are currently 3 generations of birth control pills. The division into generations is due to both a change in the amount of estrogens in the drugs and the introduction of newer progesterone analogues into the tablets.
The first generation of contraceptives include Enovid, Infekundin, Bisekurin. These drugs have been widely used since their discovery, but later their androgenic effects were noticed, manifested in deepening of the voice, growth of facial hair (virilization).
Second generation drugs include Microgenon, Rigevidon, Triregol, Triziston and others.
The most frequently used and widespread drugs are the third generation: Logest, Merisilon, Regulon, Novinet, Diane-35, Zhanin, Yarina and others. A significant advantage of these drugs is their antiandrogenic activity, most pronounced in Diane-35.
The study of the properties of estrogens and the conclusion that they are the main source of side effects from the use of hormonal contraceptives led scientists to the idea of creating drugs with an optimal reduction in the dose of estrogens in them. It is impossible to completely remove estrogens from the composition, since they play an important role in maintaining a normal menstrual cycle.
In this regard, a division of hormonal contraceptives into high-, low- and micro-dose drugs has appeared.
Highly dosed (EE = 40-50 mcg per tablet).
- "Non-ovlon"
- "Ovidon" and others
- Not used for contraceptive purposes.
Low dosage (EE = 30-35 mcg per tablet).
- "Marvelon"
- "Janine"
- "Yarina"
- "Femoden"
- "Diane-35" and others
Microdosed (EE = 20 mcg per tablet)
- "Logest"
- "Mersilon"
- "Novinet"
- "Miniziston 20 fem" "Jess" and others
Side effects of hormonal contraceptives
Side effects from the use of oral contraceptives are always described in detail in the instructions for use.
Since the side effects from the use of various birth control pills are approximately the same, it makes sense to consider them, highlighting the main (severe) and less severe.
Some manufacturers list conditions that require immediate discontinuation of use if they occur. These conditions include the following:
- Arterial hypertension.
- Hemolytic-uremic syndrome, manifested by a triad of symptoms: acute renal failure, hemolytic anemia and thrombocytopenia (decreased platelet count).
- Porphyria is a disease in which hemoglobin synthesis is disrupted.
- Hearing loss caused by otosclerosis (fixation of the auditory ossicles, which should normally be mobile).
Almost all manufacturers list thromboembolism as a rare or very rare side effect. But this serious condition deserves special attention.
Thromboembolism- This is a blockage of a blood vessel by a thrombus. This is an acute condition that requires qualified assistance. Thromboembolism cannot occur out of the blue; it requires special “conditions” - risk factors or existing vascular diseases.
Risk factors for thrombosis (formation of blood clots inside vessels - thrombi - interfering with the free, laminar flow of blood):
— age over 35 years;
- smoking (!);
- high level of estrogen in the blood (which occurs when taking oral contraceptives);
- increased blood clotting, which is observed with a deficiency of antithrombin III, proteins C and S, dysfibrinogenemia, Marchiafava-Michelli disease;
- injuries and extensive operations in the past;
- venous stasis with a sedentary lifestyle;
- obesity;
- varicose veins of the legs;
- damage to the valvular apparatus of the heart;
- atrial fibrillation, angina pectoris;
- diseases of the cerebral vessels (including transient ischemic attack) or coronary vessels;
- moderate or severe arterial hypertension;
— connective tissue diseases (collagenosis), and primarily systemic lupus erythematosus;
- hereditary predisposition to thrombosis (thrombosis, myocardial infarction, cerebrovascular accident in close blood relatives).
If these risk factors are present, a woman taking hormonal birth control pills has a significantly increased risk of developing thromboembolism. The risk of thromboembolism increases with thrombosis of any location, either currently present or suffered in the past; in case of myocardial infarction and stroke.
Thromboembolism, whatever its location, is a serious complication.
| … coronary vessels → | myocardial infarction | |
| ... brain vessels → | stroke | |
| ... deep veins of the legs → | trophic ulcers and gangrene | |
| ... pulmonary artery (PE) or its branches → | from pulmonary infarction to shock | |
| Thromboembolism... | … hepatic vessels → | liver dysfunction, Budd-Chiari syndrome |
| … mesenteric vessels → | ischemic intestinal disease, intestinal gangrene | |
| ...renal vessels | ||
| ... retinal vessels (retinal vessels) |
In addition to thromboembolism, there are other, less severe, but still inconvenient side effects. For example, candidiasis (thrush). Hormonal contraceptives increase the acidity of the vagina, and fungi reproduce well in an acidic environment, in particular Candidaalbicans, which is a conditionally pathogenic microorganism.
A significant side effect is the retention of sodium, and with it water, in the body. This may lead to swelling and weight gain. Decreased tolerance to carbohydrates, as a side effect of the use of hormonal pills, increases the risk of developing diabetes mellitus
Other side effects, such as: decreased mood, mood swings, increased appetite, nausea, stool disorders, satiety, swelling and tenderness of the mammary glands and some others - although not severe, however, affect a woman’s quality of life.
In addition to side effects, the instructions for the use of hormonal contraceptives list contraindications.
Contraceptives without estrogen
Exist progestin-containing contraceptives (“mini-pill”). Judging by the name, they contain only gestagen. But this group of drugs has its own indications:
- contraception for nursing women (they should not be prescribed estrogen-progestin drugs, because estrogen suppresses lactation);
— prescribed for women who have given birth (since the main mechanism of action of the “mini-pill” is suppression of ovulation, which is undesirable for nulliparous women);
- in late reproductive age;
- if there are contraindications to the use of estrogens.
In addition, these drugs also have side effects and contraindications.
Particular attention should be paid to " emergency contraception". These drugs contain either a progestin (Levonorgestrel) or an antiprogestin (Mifepristone) in a large dose. The main mechanisms of action of these drugs are inhibition of ovulation, thickening of cervical mucus, acceleration of desquamation (squamation) of the functional layer of the endometrium in order to prevent the attachment of a fertilized egg. And Mifepristone has an additional effect - increasing the tone of the uterus. Therefore, a single use of a large dose of these drugs has a very strong immediate effect on the ovaries; after taking emergency contraceptive pills, there can be serious and long-term disturbances in the menstrual cycle. Women who regularly use these drugs are at great risk to their health.
Foreign studies of side effects of GCs
Interesting studies examining the side effects of hormonal contraceptives have been conducted in foreign countries. Below are excerpts from several reviews (translation by the author of fragments of foreign articles)
Oral contraceptives and the risk of venous thrombosis
May, 2001
CONCLUSIONS
Hormonal contraception is used by more than 100 million women worldwide. The number of deaths from cardiovascular diseases (venous and arterial) among young, low-risk patients - non-smoking women from 20 to 24 years old - is observed worldwide in the range from 2 to 6 per year per million, depending on the region of residence expected cardiovascular -vascular risk and the volume of screening studies that were carried out before prescribing contraceptives. While the risk of venous thrombosis is more important in younger patients, the risk of arterial thrombosis is more relevant in older patients. Among older women who smoke and use oral contraceptives, the death rate ranges from 100 to just over 200 per million each year.
Reducing the dose of estrogen reduced the risk of venous thrombosis. Third-generation progestins in combined oral contraceptives have increased the incidence of adverse hemolytic changes and the risk of thrombus formation, so they should not be prescribed as first-choice drugs for new users of hormonal contraception.
The judicious use of hormonal contraceptives, including avoidance of their use by women who have risk factors, is absent in most cases. In New Zealand, a series of deaths from pulmonary embolism were investigated, and the cause was often due to a risk that doctors had not considered.
Judicious administration can prevent arterial thrombosis. Almost all women who had a myocardial infarction while using oral contraceptives were either of an older age group, smoked, or had other risk factors for arterial disease - in particular, arterial hypertension. Avoidance of oral contraceptives in these women may reduce the incidence of arterial thrombosis reported in recent studies from industrialized countries. The beneficial effect that third-generation oral contraceptives have on the lipid profile and their role in reducing the number of heart attacks and strokes has not yet been confirmed by control studies.
To avoid venous thrombosis, the doctor asks whether the patient has ever had venous thrombosis in the past to determine whether there are contraindications to the use of oral contraceptives, and what is the risk of thrombosis while taking hormonal medications.
Low-dose progestogen oral contraceptives (first or second generation) were associated with a lower risk of venous thrombosis than combination drugs; however, the risk in women with a history of thrombosis is unknown.
Obesity is considered a risk factor for venous thrombosis, but it is unknown whether this risk is increased by oral contraceptive use; thrombosis is rare among obese people. Obesity, however, is not considered a contraindication to the use of oral contraceptives. Superficial varices are not a consequence of pre-existing venous thrombosis or a risk factor for deep venous thrombosis.
Heredity may play a role in the development of venous thrombosis, but its significance as a high-risk factor remains unclear. A history of superficial thrombophlebitis can also be considered a risk factor for thrombosis, especially if it is combined with a family history.
Venous thromboembolism and hormonal contraception
Royal College of Obstetricians and Gynecologists, UK
July, 2010
Do combined hormonal contraceptive methods (pills, patch, vaginal ring) increase the risk of venous thromboembolism?
The relative risk of venous thromboembolism increases with the use of any combined hormonal contraceptives (pills, patch and vaginal ring). However, the rarity of venous thromboembolism in women of reproductive age means that the absolute risk remains low.
The relative risk of venous thromboembolism increases in the first few months after starting combined hormonal contraception. As the duration of taking hormonal contraceptives increases, the risk decreases, but it remains as a background risk until you stop using hormonal drugs.
In this table, researchers compared the annual incidence of venous thromboembolism in different groups of women (per 100,000 women). It is clear from the table that in women who are not pregnant and do not use hormonal contraceptives (non-pregnant non-users), an average of 44 (with a range from 24 to 73) cases of thromboembolism per 100,000 women were registered per year.
Drospirenone-containingCOCusers - users of drospirenone-containing COCs.
Levonorgestrel-containingCOCusers - using levonorgestrel-containing COCs.
Other COCs not specified - other COCs.
Pregnantnon-users - pregnant women.
Strokes and heart attacks when using hormonal contraception
New England Journal of Medicine
Massachusetts Medical Society, USA
June, 2012
CONCLUSIONS
Although the absolute risks of stroke and heart attack associated with hormonal contraceptives are low, the risk increased from 0.9 to 1.7 with products containing 20 mcg ethinyl estradiol and from 1.2 to 2.3 with using drugs containing ethinyl estradiol in a dose of 30-40 mcg, with a relatively small difference in risk depending on the type of progestogen included in the composition.
Risk of thrombosis of oral contraception
WoltersKluwerHealth is a leading provider of expert health information.
HenneloreRott - German doctor
August, 2012
CONCLUSIONS
Different combined oral contraceptives (COCs) have different risks of venous thromboembolism, but the same unsafe use.
COCs with levonorgestrel or norethisterone (so-called second generation) should be the drugs of choice, as recommended by national contraceptive guidelines in the Netherlands, Belgium, Denmark, Norway and the UK. Other European countries do not have such guidelines, but they are urgently needed.
In women with a history of venous thromboembolism and/or known coagulation defects, the use of COCs and other contraceptives containing ethinyl estradiol is contraindicated. On the other hand, the risk of venous thromboembolism during pregnancy and the postpartum period is much higher. For this reason, such women should be offered adequate contraception.
There is no reason to withhold hormonal contraception in young patients with thrombophilia. Pure progesterone preparations are safe with respect to the risk of venous thromboembolism.
Risk of venous thromboembolism among users of drospirenone-containing oral contraceptives
American College of Obstetricians and Gynecologists
November 2012
CONCLUSIONS
The risk of venous thromboembolism is increased among oral contraceptive users (3-9/10,000 women per year) compared with non-pregnant and non-users (1-5/10,000 women per year). There is evidence that drospirenone-containing oral contraceptives have a higher risk (10.22/10,000) than drugs containing other progestins. However, the risk is still low and much lower than that during pregnancy (approximately 5-20/10,000 women per year) and in the postpartum period (40-65/10,000 women per year) (see table).
Table Risk of thromboembolism. 
Another name for birth control pills is oral contraceptives. The principle of action is based on the content of hormonal substances in the preparations, close to those produced by the female body.
The main division of currently existing oral contraceptives is monophasic (or mini-pills, i.e. those that contain only one hormone - progesterone) and combined (containing progesterone + estrogen). This way, an additional dose of hormones enters the woman’s body, while the ovulation process is suspended (the development and release of the egg is hampered), and the mucus in the cervix interferes with the activity of sperm.
In general, when selecting birth control pills, the doctor takes into account the age, whether the woman has given birth or not, as well as the presence of hormonal disorders in the body.
Mini-pills are taken every day, starting from the first day of menstruation. If the pill is not taken on time, its effect ends after 48 hours, and the risk of conception increases significantly.
Combined medications are taken every 12 hours. If this is not done, then you must take the missed pill, even if it is already time to take the next one. In this case, the effectiveness of the product decreases for the next 7 days, so you will have to use additional contraceptives. The same applies if you need to take antibiotics while using the tablets.
Contraindications to the use of oral contraception are diseases of the gallbladder and liver, menstrual irregularities in nulliparous women, and malignant tumors. It is not permissible to take birth control pills during pregnancy, as well as; Their use is not recommended for women over 40 years of age, as well as for smokers over 35.
Possible side effects of taking oral contraceptives: false pregnancy (nausea, vomiting, breast pain, irritability, headaches, etc.), decreased libido, weight gain, thrush.
If side effects are severe, it is necessary to consult about the possibility of changing the drug. But you can change the drug or stop using it only after you finish using the package.
The action of the tablets is significantly hampered by smoking, large doses of alcohol, taking antibiotics, antidepressants, and analgesics.
During the period of taking hormonal contraceptives, not only the possibility of pregnancy is reduced to a minimum, but the menstrual cycle and pain during it are also normalized, and the risk of cancer of the breast and genital organs is reduced.
Now about common myths about the consequences of taking birth control pills. Modern contraceptives with a reduced content of hormones, the effectiveness of which is also high, are not contraindicated for young girls. In addition, the use of oral contraceptives helps to cope with skin problems (pimples and acne on the body and face).
A common claim is that birth control pills cause facial hair (mustache and beard) to grow. This myth arose at the dawn of the development of oral contraceptives (in the 60s), when the hormone content in them was quite high. Current drugs exclude this possibility. Tablets with a large amount of hormones are intended only for the treatment of gynecological diseases. Another myth is the risk of significant weight gain, which is also associated with a large proportion of hormones in some drugs.
They do not affect the development of infertility, contrary to popular belief.
Experts believe that the period of taking birth control pills can be as long as a woman needs and this will not affect her health in any way and will not have harmful consequences. On the contrary, breaks in taking oral contraceptives are undesirable. Since the body has to adapt from one mode to another.
Pregnancy can occur within 1-2 months after stopping taking oral contraceptives.
Rules for taking hormonal contraceptives. You should take the tablets at the same time every day. Before starting use, carefully read the instructions and clarify all your questions with your doctor. Sufficient protection against unwanted pregnancy is guaranteed only from the time of taking the second package of the drug.
Remember that it is best to always consult your doctor regarding birth control pills and their consequences. After all, any advertising will not give you accurate and objective data. Only a true professional can do this. Remember also that oral contraception will not protect you from sexually transmitted diseases.
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